This invention relates generally to medical devices, and more particularly to a surgical hand support for performing surgical procedures on the volar side of the human thumb.
Surgical procedures on the volar, or palm, side of the thumb, are relatively common and include effective procedures such as A1 pulley (trigger thumb) release and urgent or relatively urgent reparative procedures following trauma such as for repair of flexor tendons or digital nerves or arteries. The contour of the human hand and thumb are such that with the hand laying flat, facing palm up, the thumb sits in a relatively pronated position, that is, rotated such that it's volar surface faces somewhat towards the radially side of the index finger rather than facing directly upward. This position facilitates pinching activity between the thumb and index finger and other digits, as well as use of the thumb during gripping activities. For many surgical procedures on the thumb, however, this natural position of the thumb relative to the hand makes it difficult to maintain the thumb in a position that allows appropriate access and visualization of the areas of interest on the volar side of the thumb by simple positioning of the hand in the usual manner, i.e., with the hand lying flat with the palm facing upward.
Usually, an assistant or the surgeon must manually hold the thumb and hand in such a way as to present or expose the volar side of the thumb directly to the operating surgeon and maintain the thumb in a stable position to be worked upon. Normally, retractors must also be manually held within the surgical wound to allow visualization of the deeper structures by the surgeon. For even a relatively simple procedure such as an A1 pulley release of the thumb, three or four retractors may need to be held simultaneously along with the holding or maintaining of the thumb itself in an appropriate position.
If limited assistance is available, such as is the situation with a surgical case being done by a single surgeon with a single scrub technician or scrub nurse assisting, holding all of the necessary objects (thumb and retractors) can be extremely awkward, cumbersome or impossible with the available number of hands. If the scrub assistant has one or both hands involved holding the thumb and hand, he or she may not be able to hold necessary retractors or reach for and hand to the surgeon instruments needed to perform the operation.
For procedures being done under magnification, particularly under an operating microscope, manually holding the thumb may cause an unacceptable amount of shaking for repairing a nerve or artery even with a steady handed assistant. This can make the procedures more difficult and more time consuming. In addition, the very expensive rate for the operating room in this instance can cause significant cost increases for such surgical procedures.
A principal object of the present invention to provide a table or support which secures the hand and thumb in the appropriate position for volar surgery to the thumb without requiring manual holding by an assistant, and which will steadily retain the hand and thumb in position while doing fine microscopic procedures.